Breast Reconstruction with TRAM Flap

Traditional breast conservative therapy (BCT) is lumpectomy, sentinel lymph node biopsy and possible axillary dissection, and radiation therapy. BCT is, as known and considered all over the world, is oncologically equivalent to mastectomy with regard to overall long-term survival rates. BCT is the recommended treatment of choice for women with early stages breast cancer. The main philosophy of BCT is optimizing cosmetic goals and minimizing the psychological morbidity of a mastectomy while ensuring low rates of local recurrence. Achieving an oncologically safe resection is maintained by tumor margin clearance. Ensuring an oncologic clearance with increasing tumor size requires extensive breast parenchyma resection. And this results in large volume resection and this requires volume replacement techniques. Depending on the amount of breast volume resected, an autologous tissue transfer may be required to achieve requirement of breast restoration. Latissimus dorsi flap and TRAM flap are two autologous tissues mostly used to fulfill this restoration. This chapter focuses on the TRAM flap, one of the most commonly used autologous tissue in volume replacement reconstruction of the mastectomy defect

Listening to Voices of the Future: contributions from people born after 1985

The six articles that follow are contributions from eight people born after 1985. They represent a response to the invitation we published in the August 2019 issue of Policy Quarterly (Coleman and Karacaoglu, 2019). We hope that what follows is a valuable contribution to various intergenerational conversations that are taking place in New Zealand and around the world

Listening to Voices of the Future: an invitation to contribute to a special issue of Policy Quarterly on cohortbased or generation-based policies

We would like to invite people to explore ways that public policies can be designed to facilitate the process of change. Our focus is specifically and deliberately on generational change – how society can best enable change when younger and older generations have very different views on what is important, what is possible and what is desirable. We want to explore how successive generations can shape the future so that it better reflects their issues and concerns. These changes do not concern just age, but can cover a broad canvas of themes related to issues such as gender or ethnicity, or the environment

Calf contouring with endoscopic fascial release, calf implant, and structural fat grafting

Departamentul de Chirurgie Plastică, Spitalul Memorial Ataşehir, Istanbul, Turcia, Departamentul de Chirurgie Plastică, Brown University School of Medicine, Providence, Statele Unite ale Americii, Departamentul de Chirurgie Plastică, Spitalul International Medpark, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Gambele curbe sunt cauza unui stres psihologic pentru femei. După evaluarea aspectului estetic şi formei gambelor, dacă grosimea excesivă este factorul ce contribuie cel mai mult, sunt considerate procedurile de lipoplastie şi reducere musculară. Dacă picioarele sunt zvelte, nu prezintă hipertrofie musculară dar totuşi au o identaţie şi proeminenţă laterală traduse printr-un neajuns estetic, care ar fi opţiunile? Răspunsul la această întrebare este discutat în această lucrare. Material şi metode: Douăzeci şi două de paciente, operate timp de 5 ani (2007-2012), au fost incluse în acest studiu. O tehnică operatorie nouă a fost introdusă în practică. Pentru a obţine rezultate optime această metodă necesită eliberarea endoscopică a fasciei ce acoperă partea medială a muşchilor gambieni cu augmentare simultană cu implanturi gambiene, liposucţie şi grefă structurală de grăsime. Rezultate: Toate pacientele au fost urmărite în perioada postoperatorie pe parcursul unei perioade medii de 31 de luni. Procedura a fost bine tolerată, cu disconfort minim în perioada postoperatorie. Creşterea proximală şi distală în diametru a gambelor a fost măsurată la 6 luni după intervenţie. Modificarea medie a diametrului gambian proximal a constituit 2,16 cm şi 1,77 cm a celui distal. Concluzii: A fost aplicată o metodă nouă endoscopică pentru conturarea gambelor. Tehnica fasciotomiei endoscopice cu implanturi gambiene şi grefă structurală de grăsime pentru îmbunătăţirea estetică a acestei parţi a piciorului este simplă, efectivă, de încredere şi previzibilă pentru conturarea gambelor.Introduction: Curved lower legs cause psychological stress for women. In evaluating the shape, if thickness is the main contributing factor of leg aesthetic, then lipoplasty or calf reducing procedures will be the option. If the legs are slender and have no muscle hypertrophy but still have some indentation or bulges on both sides and lack an aesthetic shape what will be the options? The answer to the question above is discussed in detail in this article. Material and methods: Twenty-two patients, operated over a period of 5 years from 2007 to 2012, were included in the study. A novel technique has been introduced. This method requires release of fascia covering muscles of the inner leg bulge via endoscopic approach and simultaneous calf augmentation with calf implant, liposuction, and structural fat grafting to optimize the results. Results: Patients were followed on a regular basis with a mean follow-up of 31 months. The procedure was well tolerated with minimal discomfort during the postoperative period. Increase in diameter of proximal and distal lower legs was measured at least 6 months after surgery. Mean diameter change of proximal lower legs was 2.16 cm and 1.77 cm in distal lower legs. Conclusions: A novel endoscopic approach for lower leg contouring is discussed. Endoscopic fasciotomy technique with calf implant and structural fat grafting for improved lower leg aesthetics is a simple, effective, reliable, and predictable technique for calf contouring

Enhanced Liposuction for Arms

Arm contouring is a desired goal of the arm esthetics. Brachioplasty is a developing and safe surgery to improve the arm silhouette but scar is a one of the most distracting factor for both patients and surgeons. In this chapter conventional liposuction with laser assisted liposuction (LAL) is proposed to yield satisfactory results in selected group of patients. Classification systems are helpful to decide for proper patient selection for this technique. It includes assessment of fat excess, skin excess, and location of the deformity (proximal, entire arm, arm and chest). Patients with minimal to extensive fat deposits plus minimal to moderate skin laxity are the best candidates for this approach. When properly performed, with realistic expectations, liposuction and LAL combination is considerably a procedure of choice for arm contouring in these selected cases. The contraction of arm skin is considerably consistent. Our approach, except in the most extreme cases, is to initially recommend liposuction and possibly even a second liposuction prior to recommending brachioplasty. An esthetically pleasant result can be obtained even in massive arms with good skin tone. Massive arms with poor skin tone, however, may not. Patient selection and preoperative planning are discussed in detail. A thorough description for patient positioning and anesthesia options are studied. The technique of the liposuction is widely described including specific regional contour goals with artistic attention to enhance the contour. Refinement regarding skin tightening and skin surface smoothness are also discussed. Arm contouring is a growing field of body contouring and can be practiced with low complication rates and high patient satisfaction. Available classification systems help to select proper patient group. Laser assisted fat removal combined with conventional liposuction are promising procedures for selected patients

CAD techniques for microwave circuits

In little more than 10 years computer-aided design (CAD) of microwave circuits has moved from dumb terminals on mainframe computers to PCs, and now to powerful RISC workstations. Commercial CAD software now integrates the various stages of microwave circuit design: schematic capture, simulation and layout. This paper reviews the different CAD packages that are available for microwave circuit design. The basic principles employed in the modelling of microstrip circuits are introduced and the reasons for the extensive use of frequency-domain simulations are explored. The developments in nonlinear, electromagnetic and system-level simulation methods are described.The authors would like to acknowledge the financial support of the Engineering and Physical Sciences Research Council, and the Comisidn Interministerial de Ciencia y Technologia (CICr?‘), Spain, under the project TIC95-0983-C03-02. We would like to thank Hewlett Packard, Barnard Microsystems, Sonnet Software, Optimization Systems Associates, Kimberley Communications Consultants and Ansoft Corporation for their generous educational discounting. The assistance of Dr. D. M. Brookbanks at GEC-Marconi Materials Technology Ltd. (Caswell) is gratefully acknowledged

Harmonic suppression in microstrip dual-mode ring-resonator bandpass filters

This paper introduces two new topologies for rejecting the harmonics in microstrip ring resonator filters. First one uses 50 Ω spur line filter structures placed at the input and output of the ring to suppress the first harmonic. Second topology incorporates low-pass structures into the ring for elimination of the harmonic

Photoluminescence properties of Eu3+-activated Y1.50Sc0.50O3 phosphors

In this research, Eu3+ activated and Dy3+-co-doped Y2O3 based phosphors have been synthesized by solid-state reaction method under open atmosphere. The host lattice is composed of 0.25 moles of Sc2O3 which is added to phosphor composition. Thus, Sc3+ substitution of Y3+ ions is implemented to form Y1.40Sc0.50O3 host lattice. The thermal analysis (DTA/TG) have been carried out from 50 °C to 1400 °C for preliminary examination of thermal behavior of phosphors during heat treatments. After the heating process, the phase formations are characterized by X-ray diffraction resulted as Y2O3 single phase cubic structure. The effects of Eu3+ and Dy3+ dopant ions on the photoluminescence and phase formation properties of the hosts are investigated and determined as Dy3+-co-doped phoshor has the reduced excitation/emission intensities as well as decay lifetimes